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Perfusionist

This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Fusion Medical Staffing.

  • 0 = Not Applicable
  • 1 = No Experience
  • 2 = Some Experience
  • 3 = Intermittent Experience
  • 4 = Experienced
  • 5 = Very Experienced
*Required
n/a
1
2
3
4
5

* Required

Age of Patients Cared For

Newborn/Neonate (birth to 30 days)*

Infant (1 month to 1 year)*

Toddler (1 year to 3 years)*

Preschooler (3 years to 5 years)*

School Age Child (5 years to 12 years)*

Adolescents (12 years to 18 years)*

Young Adults (18 years to 39 years)*

Middle Adults (39 years to 64 years)*

Older Adults (64 years to 79 years)*

Elderly Adults (over 79+ years)*

General Skills

Standard Precautions*

Isolation Precautions*

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Crash Carts*

Defibrillators*

Electronic Documentation*

Automated Med Dispensing Systems*

Basic Concepts

Cardiovascular Anatomy*

Pathology and Surgical Repair*

Physiology*

Pharmacology*

Physics*

Chemistry*

Mathematics*

Immunology*

Technology, Equipment, And Techniques

Extracorporeal Circuit Components for Cardiopulmonary Bypass*

Adequacy of Perfusion*

Myocardial Preservation*

Systemic Hypothermia*

Blood Conservation Techniques*

Catastrophe Management*

Adjunctive Techniques*

Patient Monitoring*

Organ Transplantation*

Cardiopulmonary Bypass (CPB)

Set-up/Priming of Equipment*

Initiation of CPB*

Administration of Prescribed Fluids/Medications*

Anticoagulation*

Temperature Management*

Acid-Base Management*

Ultrafiltration*

Flow Rates*

Cardioplegia*

Hypothermic Circulatory Arrest*

Power Failure*

Pump Failure*

Oxygenator Failure*

Massive Air Embolus*

Weaning/Resumption of Natural Circulation*

Mechanical Assist Techniques

Ventricular Assist Device (VAD)*

Intra-Aortic Balloon Pump (IABP)*

Extra Corporeal Membrane Oxygenation (ECMO*

Extra Corporeal Life Support (ECLS)*

Lab Analysis

Special Chemistry*

Blood Chemistry*

Coagulation*

Additional Practices

Off Pump Surgery Conversion to CPB*

Autologous Blood Salvage*

Limb Perfusion*

Left Heart Bypass*

Minimally Invasive (Percutaneous) Bypass*

Minibypass*

Liver Perfusion*

Platelet Gels*

Retrograde Cerebral Perfusion*

Selective Antegrade Cerebral Perfusion*

Other Skills
Application Agreement

The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

By completing this Skills Checklist, you agree to receive calls, AI-generated calls, text messages, or emails from and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at Privacy Policy.